Summary of findings 2.
Structured decision aid on feeding options
| Structured decision aid on feeding options | ||||||
| Patient or population: people with advanced dementia Setting: nursing homes Intervention: structured decision aid on feeding options Comparison: usual care | ||||||
| Outcomes3 | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with usual care | Risk with structured decision aid on feeding options | |||||
| Decisional conflict in family/carers assessed with: Decisional Conflict Scale Scale from 0 to 100, lower indicates less decisional conflict Follow‐up: mean 3 months | The mean decisional conflict in family/carers was 1.93 on the Decisional Conflict Scale | The mean decisional conflict in family/carers in the intervention group was 0.3 lower on the Decisional Conflict Scale (0.61 lower to 0.01 higher) | ‐ | 90 (1 RCT) | ⊕⊝⊝⊝ Very low 1,2 | Only a subset of the study population met the review inclusion criteria, so re‐analysis of data from subset required. |
| Discussion on feeding with physician/nurse/physician assistant Follow‐up: mean 3 months | Study population | RR 1.57 (0.93 to 2.64) | 90 (1 RCT) | ⊕⊝⊝⊝ Very low 1,2 | Only a subset of the study population met the review inclusion criteria, so re‐analyse of data from subset required. | |
| 31.8 per 100 | 50.0 per 100 (29.6 to 84.0) | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1 Downgraded one level for serious risk of bias (high risk of bias due to lack of blinding of participants and of outcome assessors).
2 Downgraded two levels for very serious imprecision (small sample size and wide confidence intervals).
3 This 'Summary of findings' table shows only outcomes measured in this comparison.